Pre-Access Trainer/Auditor - FT - Days at AdventHealth

Date Posted: 2/7/2020

Job Snapshot

  • Job Schedule
    Full-Time
  • Job Category
  • Date Posted:
    2/7/2020
  • Job ID:
    19026492
  • Job Family
    Patient Financial Services
  • Travel
    No
  • Shift
    1 - Day
  • Application Zone
    1-Shared Services
  • Organization
    AdventHealth Daytona Beach

Job Description


Description

GENERAL SUMMARY:

Pre Access Auditor/trainer, under the direct supervision of the Pre Access Director, compiles monthly statistics of department accuracy rate and identifies areas of opportunity, works on reeducation planning and coaching to address issues found while auditing.  Coordinates training classes for new hires and on-going training on new information or procedures for all team members in the Pre Access Department.  Maintains department manuals and training material.

PRINCIPAL DUTIES AND JOB RESPONSIBILITIES:

•       Works following Pre-registration reports daily and corrects insurance/registration errors.

•       Listens in to scheduling and pre-registration calls for quality assurance and training purposes.

•       Runs daily scheduling reports to ensure all encounters are completed timely with appropriate insurance mnemonics and no encounters are left without verification and/or authorizations.  Verifies that orders match the service scheduled.

•       Daily listing of Registration Reports to ensure no dashes or spaces in policy numbers and that all patient birthdates are entered.

•       MCRA/MCRAA Report to ensure suffix and prefixes are entered on all Medicare policy numbers in registration.

•       Patients by Financial Class to ensure all Blue Cross insurances are registered with correct mnemonic and all insurances that require authorizations have been completed.

•       MVA/WCOMP to make sure occurrence codes and employment information is entered correctly with proper dates for billing.

•       Other Insurance Report to make sure all insurance under other insurance mnemonic has proper billing information entered.

•       Medicaid report to check every Medicaid with WebMD to make sure we have proper Medicaid, policy number and authorization entered on all Medicaid Registrations.

•       PPO Report to ensure all PPO is entered correctly.

•       Other audit reports as created.

•       Ensures Insurance requirements and authorizations are obtained to guarantee proper reimbursement.

•       Possess knowledge of Insurance Companies and their requirements for Out Patient procedures and testing.

•       Knowledge of on-line verification systems including but not limited to Availity, WebMD and United Healthcare.

•       Medical Necessity training and understanding

•       Complete understanding of LMRP software programs.

•       Ability to train staff on Medical Necessity requirements.

•       Knowledge of CPT and ICD-10 manuals.

•       Complete New Hire Training and Staff in-services.

•       Update and compile training material for all registration staff.

•       Provide 2 week hands-on training programs with all new registration staff in a classroom setting on Pre Access policies, Cerner and Series entry and registration processes.

•       Complete new hire testing of competencies.

•       Complete 2 month follow up with all new hires for additional training requirements.

•       Meet with Registration Supervisory staff to ensure new hire competencies are at meeting department demands.

•       Provide training to registration staff outside of the Pre Access Registration Department.

•       Completed continuing education to all registration staff and outside registration staff.

•       Provides feedback to supervisory staff of employee’s levels.

•       Assists Department Manager with other tasks as assigned.

 


Qualifications

KNOWLEDGE AND SKILLS REQUIRED:

•       Computer and typing training required.

EDUCATION AND EXPERIENCE REQUIRED:

•       Requires a high school diploma or GED. 

•       Three (3) years’ Patient Access Experience required. 

•       One (1) year Training Experience required.



This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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